This invention relates to a novel apparatus for effecting surgical anastomosis by means of laser welding. More specifically, this invention relates to novel surgical apparatus for directing a laser beam circumferentially around the juxtaposed ends of a pair of tubular tissues surgically to weld them together.
In recent years the use of laser technology in medicine and surgery has extended beyond its early use in the field of ophthamology, and is now being employed in general and tumor surgery, otolaryngology, orthopedic surgery, urology, etc. Most recently it has been used in connection with the welding of body tissues, as taught, for example, by U.S. Pat. No. 4,143,660, wherein a laser beam of the argon, carbon dioxide or neodymium garnet variety was directed by a flexible cord of light fibers linearly across the clamped section of a hollow organ, so as surgically to weld together the opposed side walls of the organ. The disadvantage of equipment of this type is that, because of its massive size, it can be used only to seam together, or perhaps to cut through the two superimposed tissue sections which are clamped together. With this type of apparatus, therefore, it is not possible to effect a satisfactory end-to-end anastomosis of tubular tissues, whereby the confronting ends of the tissues retain their tubular configurations.
Efforts heretofore have been made to use a carbon dioxide laser for sutureless anastomosis of fallopian tubes (von Klitzing L., Grosspietzsch R., Klink F., et al., "Surgical Refertilization by means of a Laser Technique", Fortschr-Med, 96 (7): 357-9, Feb. 16, 1978; and Klink F., Grosspietzsch R., von Klitzing L. et al., "Animal in Vivo studies and in Vitro experiments with human tubes for end-to-end anastomotic operation by a CO.sup.2 laser technique", Fertil-Steril, 30 (1): 100-102, July, 1978); and a laser, rather than sutures has been used to achieve anastomosis in the case of extra-intracranial bypass operations (Jain KK: "Sutureless extra-intracranial anastomosis by laser", Letter to the Editor, the Lancet, 2(8406): 816-817, Oct. 6, 1984). Moreover, in certain cases a stent has been used to hold together the confronting ends of tubular tissues during sutureless anastomosis by laser welding, but the procedure has not been satisfactory, because it has been necessary manually to manipulate the tissues in order to expose the desired surfaces thereof to the laser beam. This makes it almost impossible to produce an accurate seam, and in many instances the procedure is precluded because of the very location of the tissues.
It is an object of this invention, therefore, to provide a novel apparatus for effecting a perfect end-to-end anastomosis of two tubular tissues by laser welding them together without causing any undesirable collapse of the confronting ends of the tissues, and without requiring any manual manipulation of the tissues during the welding operation.
A more specific object of this invention is to provide novel apparatus for manipulating a laser beam in a predetermined manner relative to human tissue in order to effect laser welding of the tissue in a predetermined manner, and along a predetermined circular path.
Other objects of this invention will be apparent hereinafter from the specification and from the recital of the appended claims, particularly when read in conjunction with the accompanying drawings.